10D2216023 CLIA NUMBER - MINDFUL BEHAVIORAL HEALTHCARE LLC

Laboratory Demographics

  • CLIA Code: 10D2216023
  • Facility Name: MINDFUL BEHAVIORAL HEALTHCARE LLC
  • Facility Address: 711 E OAK STREET
    KISSIMMEE, FL
    ZIP 34744
  • Facility Phone: 407 846-0533
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: VIVIAN CHARNECO
  • NPI Number: 1477744548
  • Taxonomy: 251S00000X - Community/Behavioral Health

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CLIA Record

Field Name Field Value
CLIA Number 10D2216023
LAB Type Physician Office
Facility Name MINDFUL BEHAVIORAL HEALTHCARE LLC
Street 711 E OAK STREET
City KISSIMMEE
State FL
ZIP 34744
Phone 407 846-0533
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 3/9/2025
Certificate Expiration Date 3/8/2027
Facility Type Physician Office
Lab Director VIVIAN CHARNECO

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This page was last updated on: 6/4/2025